Rapid advances in biotechnology and medical interventions have great potential to improve health but can bring un-anticipated risks. Even treatments that have shown great promise in clinical trials need to be evaluated further as they are adopted in community practice and provided to a broader range of patients. There is a need for new models and approaches to technology assessment and national adoption that maximize the potential benefits by providing for the timely introduction of promising devices and treatments while ensuring their ongoing evaluation and appropriate and safe utilization following their introduction in clinical practice. The current proposal focuses on a timely opportunity to develop a new outcomes-based model. By focusing on the new procedure of carotid artery stenting (CAS) for high risk patients as a case study this proposal will bring together clinical, methodological and other experts to develop a blueprint for a national registry program intended to lead to the implementation of rigorous performance monitoring and quality improvement efforts. Such a blueprint may have the potential to be implemented and/or required by public and private health care payers for payment. The focus on CAS as a case study will also improve quality of care for priority populations, including the elderly. As a result of the conference, we will prepare a manuscript intended for publication outlining the features and rationale for a new blueprint for the use of registries in promoting patient safety, quality improvement and accountability. Moreover, a full grant proposal will be developed for the implementation and comprehensive evaluation of such a registry for CAS. The proposed conference date is October 15, 2005.